The overall objectives of this project are to examine and analyze the various techniques that genetic counselors use to manage their own uncertainties with regard to all aspects of the counseling endeavor---diagnosis, establishing risk of reocurrence and patient management; to examine and analyze how a new clinical specialty emerges and establishes its place in a highly structured division of labor; that is, how referral relationships with colleagues are negotiated; how boundary problems with competing specialties are managed; and how a sense of "mission" purpose, and identity emerges among genetic counselors and is communicated to other physicians, to clients, and to concerned publics and to explore special problems of participant-observers in medical settings to improve the reliablity, validity, and accountability of observational studies in natural settings. Data is now being collected by participant-observation at two different centers.